Retroperitoneal perforation of the rectum during barium enema examination

Colorectal perforation during barium enema examination is rare. The authors report the case of an 84-year-old woman in whom retroperitoneal perforation of the rectum occurred during barium enema examination. Potential mechanisms of injury include trauma, overinflation of the balloon, recent instrumentation and associated disease of the rectal mucosa. When the colon has been well prepared before examination, and air alone, not barium, has been insufflated into the retroperitoneum, then such injuries may be managed successfully without operation, as in this case.